• 대한한방부인과학회지
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• 제21권3호
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• pp.218-230
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• 2008

Purpose: This study was performed to investigate the percentage of the oriental medical Ob & GY disease group in Korean Medical Health Insurance and to gain the basic data of enlargement and improvement of Acupuncture Benefits in the oriental medical Ob & Gy field. Methods: We requested data about the status of Insurance Benefits in 2005. 2006 to Health Insurance Review & Assessmenstatus Service(HIRA). And on the basis of this 2005. 2006 data, we analyzed the status of Insurance Benefits and Acupuncture Benefits in the oriental medical Ob & Gy disease group. Results: 1. Total health care benefit costs of Korean medical health insurance in 2005, 2006 took 4.38 percent and 4.25 percent of total health care benefit costs of Health insurance. 2. Total health care benefit costs of the oriental medical Ob & Gy disease group in 2005, 2006 took 0.38 percent and 0.40 percent of total health care benefit costs of Korean medical health insurance. 3. The percentage of Acupuncture benefits costs of the oriental medical Ob & Gy disease group in 2005, 2006 was merely 0.22 percent and 0.23 percent of total Acupuncture Benefits costs. 4. The main sick and wounded name of Ob & Gy diseases of Acupuncture Benefits was limited to Menstrual Disorder(K01)과- Uterus Abnormality(K13). Conclusion: The percentage of the oriental medical Ob & Gy disease group in Korean Medical Health Insurance was very low and the percentage of Acupuncture Benefits of he oriental medical Ob & Gy disease group was also very low. From now on, Searching ay of enlargement of Acupuncture Benefits in the oriental medical Ob & Gy field is required.

• 한국유기농업학회지
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• 제24권3호
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• pp.369-383
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• 2016

Crop yield insurance program in Korea has rapidly grown not only in quantity but in quality for 15 years since it was introduced in 2001. Despite growth of Crop insurance, performance evaluation for crop yield insurance has not fully been evaluated at the farm, consumer and national level. The purpose of this study is to conduct the performance evaluation for crop yield insurance through estimating the effects of farm revenue stabilization and social welfare increase with three popular insurance items: apple, pear and sweet persimmon. Based on the analysis of social welfare effect, cost-benefit analysis of operating crop yield insurance was conducted at the national level. We found that crop yield insurance stabilizes farm revenue based on the estimated four risk indicators: Coefficient of Variation, Value at Risk, Certainty Equivalence, and Risk Premium. The result of cost-benefit analysis shows that crop yield insurance increases social net benefit by 44.1 billion won for the three items. As a result, crop yield insurance program has contributed remarkably on social welfare as well as farm management and its role will be more important in the future.

• Journal of Preventive Medicine and Public Health
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• 제24권2호
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• pp.211-220
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• 1991

Finances of health insurance can be explained by factors determining benefit expense and premium collection. This study was conducted to analyze factors contributing to the financial status of rural health Insurance. Nationwide 134 health insurance associations except the six pilot project counties were analyzed and obtained the followings. 1. In univariate analysis, statistically significant variables that explain 1) outpatient benefit expenditures include public health center utilization, proportion of pregnant women. premium and collection rate of premium 2) inpatient benefit expenditures include public health center utilization, Proportion of old age, proportion of pregnant women, premium and collection rate of premium 3) profits include public health center utilization, proportion of old age, proportion of pregnant women and collection rate of premium. 2. In multiple regression analysis, statistically significant determinants in 1) outpatient benefit include premium and public health utilization 2) inpatient benefit include premium 3) profit include public health center utilization, premium and collection rate of premium.

• Journal of Preventive Medicine and Public Health
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• 제22권3호
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• pp.398-405
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• 1989

A change in the consumer's surplus was measured in order to evaluate the social benefit to be derived from expanding health insurance to the entire population. The most refined and correct way to measure a project's net benefit to society is to determine a change in the consumer's surplus. Benefits from introducing the health insurance program to the uninsured people can be classified into two elements. The first is the pricing-down effect(E1) which results from applying the insurance price system, which is lower than the actual price, to the uninsured patients. The second effect(E2) is a decrease in actual payment because an insured patient pays only a portion of the total medical bill(copayment). We collected medical price information from the data banks of 93 hospitals, and obtained information of medical utilization by referring to the results of other research and from data published by the Korean Medical Insurance Societies. The total net benefit was estimated as \214 billion, comprising the first effect(E1) of \57 billion and the second effect(E2) of \157 billion. The price elasticity of physician visits is less than that of hospital admissions: however, benefits from the increase in physician visits are greater than those from hospital admissions because there are considerably more of physician visits than hospital admissions. The sensitivity analysis also shows the conclusion that expansion of the health insurance program to the entire population would result in a positive net benefit. Therfore, we conclude that the National Health Insurance Program is socially desirable.

• 보건행정학회지
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• 제27권1호
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• pp.30-38
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• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

• 대한본초학회지
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• 제21권4호
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• pp.1-10
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• 2006

Objectives : Recently, the total medical expenses of the korean oriental medical service in national health insurance is on the increase every year. Herbal medicines are one of the major methods of the medical treatment. But the expenses of these herbal preparations that can receive benefits from insurance system are decreasing. Methods : In this research, we obtained statistical data of the benefit states of herbal preparations in herbal heath insurance during year 2001-2003 from Health Insurance Review Agency. We analyzed top twenty main diseases in herbal health insurance and mainly used prescription in these diseases. Results : There were wide differences in the application of prescriptions among diseases. For example, musculoskeletal diseases occupied an important position and Ojucksan took more than 50 percentage. Conclusion : We hope that this study could be a basic data for improving the benefit system of herbal health insurance and further studies should be carried out subsequently.

• 보건의료산업학회지
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• 제5권2호
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• pp.157-172
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• 2011

The purpose of this study is to provide basic information for improving medical security between the Korean National Health Insurance Corporation and the private health insurance in Pusan Metropolitan area by investigating of the recognition with the benefit groups. Questionnaires of 431 were taken between Feb. 11th and Feb. 25th 2008. The survey was carried out to gather information about SES and contents of insurance and recognition between the benefit group of the Korean National Health Insurance and the private health insurance on the financial conditions and the stability. The result of survey is as follows. First, there is a difference between the National Health Insurance and the private health insurance on the financial conditions and the stability of the Korean National Health Insurance. Second, there is a high score at the private health insurance on the financial conditions and the stability of the private health insurance. Third, privatizing of a National Health Insurance is high score at increase of the premium, medical payments of the National Health Insurance group and is high score at enhance of quality of medical service and decrease of loss of medical payment of the private health insurance group. Therefore, to provides more information and improved medical security with the benefit group. it is necessary for concerns to put more efforts in creating Conflicting vs. Complementing of systemic base.

• 노동경제논집
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• 제27권1호
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• pp.77-105
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• 2004

본고는 저축을 통한 자가보험이나 실업급여가 현실적으로 제한되어 있는 상황에서 실직자에게 실업급여뿐 아니라 미래 연금을 담보로 한 대출을 허용하는 새로운 실업자 보호 제도를 제시하고 그 실증적 효과성을 패널자료에 의해 분석하고 있다. 이 제도는 실직자들이 미래 소득을 담보로 대출을 받아 효과적 자가보험을 갖도록 함으로써 실업급여에 비해 구직유인을 유지하게 할 뿐 아니라 소비 균등화 및 실직위험 부담 완화를 꾀할 수 있도록 한다. 본고는 경제활동인구조사에 근거한 1998~2002년 패널자료를 이용하여 시뮬레이션하였고 그 결과 기존 실업급여제도 하에서 보조를 받고 있는 저학력 계층도 실업급여보다는 연금담보 대출을 더 선호한다는 사실을 보고하고 있다. 이 결과는 연금담보 대출의 소비 균등화 및 구직유인 강화에 의한 후생증대 효과가 매우 강력함을 시사하고 있으며, 제한적인 효과밖에 갖지 못하는 기존 실업급여제도를 대체할 수 있는 새로운 실직자 보호정책 대안이 될 수 있음을 보여주고 있다.

• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.104-107
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• 2023

The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

• 한국치위생학회지
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• 제16권4호
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• pp.539-548
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• 2016

Objectives: The purpose of the study is to investigate the awareness and attitude toward health insurance coverage extension to scaling in dental service consumers. Methods: A self-reported questionnaire was completed by 349 adults in Jeonbuk from May 4 to 15, 2015. The questionnaire consisted of general characteristics of the subjects (7 items), Awareness of the dental health insurance system(8 items), Health insurance system coverage extension to scaling(8 items), Self-perception of oral health(7 items), Recognition toward yearly scaling benefit(10 items). Results: There were significant differences according to age in opinions on the appropriateness of the frequency of yearly scaling benefit, and the respondents who were in their 20s, who were unmarried and who brushed their teeth three times a day had significantly different opinions on the appropriateness of the fee of yearly scaling benefit. Their opinions on the expansion of scaling benefit was significantly affected by age. It implies that scaling should be added to the coverage list of the national health insurance in every age group since there is an increase in periodontal diseases with age. Concerning awareness of dental health insurance policy, the better-educated respondents took a better view of this system as they showed a more positive interest in its policies and shifts. Conclusions: It is desirable to provide more precise information as to eligible age, frequency and cost through public promotion of health coverage of scaling, and the effort to improve the health insurance coverage policy should be made in order to extend the scope of health coverage of scaling in the near future.